Ccs General Quiz IV
Questions and Answers
- 1.
__________ multiplied by conversion factor gives you the amount payable for a providers fee schedule.
- A.
OPPs
- B.
NECs
- C.
RVUs
- D.
BBCs
Correct Answer
C. RVUsExplanation
Relative Value Units. The CASE mix index is a relative value unit (DRG) assigned for a period of timeRate this question:
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- 2.
Encounter for gastrostomy tube irrigation if indexed under ______________, gastrostomy
Correct Answer
attention toExplanation
The correct answer is "attention to." This suggests that when looking for information about an encounter for gastrostomy tube irrigation, one should search under the keyword "attention to" rather than "gastrostomy tube irrigation." This implies that "attention to" is the more relevant or commonly used term in medical documentation for this type of procedure.Rate this question:
- 3.
Cyanosis is not coded with respiratory or cardiac arrest
- A.
IS
- B.
IS NOT
Correct Answer
B. IS NOTExplanation
Cyanosis is the bluish discoloration of the skin or mucous membranes due to a lack of oxygen in the blood. It is a symptom that can occur in various medical conditions, including respiratory or cardiac arrest. However, the given statement suggests that cyanosis is not coded specifically with respiratory or cardiac arrest. This means that while cyanosis can be present in these situations, it is not the primary code used to describe them. Other codes would be used to indicate the underlying cause of the arrest, while cyanosis may be mentioned as an associated symptom.Rate this question:
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- 4.
When the question tells you that the pt has died, be suspicious. Certain conditions recieve a CC/MCC only if the pt is discharged alive! i46.2 cardiac arrest due to underlying cardiac condition i46.8 cardiac arrest due to other underlying condition i46.9 cardiac arrest, cause unspecified i49.01 ventricular fibrillation r09.2 respiratory arrest r57.0 cardiogenic shock r57.1 hypovolemic shock r57.8 other shock
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
When the question tells you that the patient has died, it is important to be suspicious because certain conditions receive a CC/MCC only if the patient is discharged alive. This means that if the patient has died, these conditions may not be applicable or relevant in the context of the question. Therefore, the statement "True" is correct in this case.Rate this question:
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- 5.
Which of the following conditions is on the HAC list?
- A.
Diabetic foot ulcer
- B.
Diabetic Ketoacidosis
- C.
B and D are correct
- D.
Blood Incompatibility
Correct Answer
D. Blood IncompatibilityExplanation
Stage 3 and 4 ulcers are on the HAC list
HAC's....................
Foreign Object Retained After Surgery
Air Embolism
Blood Incompatibility
Stage III and IV Pressure Ulcers
Falls and Trauma
Fractures
Dislocations
Intracranial Injuries
Crushing Injuries
Burn
Other Injuries
Manifestations of Poor Glycemic Control
Diabetic Ketoacidosis
Nonketotic Hyperosmolar Coma
Hypoglycemic Coma
Secondary Diabetes with Ketoacidosis
Secondary Diabetes with Hyperosmolarity
Catheter-Associated Urinary Tract Infection (UTI)
Vascular Catheter-Associated Infection
Surgical Site Infection, Mediastinitis, Following Coronary Artery Bypass Graft (CABG):
Surgical Site Infection Following Bariatric Surgery for Obesity
Laparoscopic Gastric Bypass
Gastroenterostomy
Laparoscopic Gastric Restrictive Surgery
Surgical Site Infection Following Certain Orthopedic Procedures
Spine
Neck
Shoulder
Elbow
Surgical Site Infection Following Cardiac Implantable Electronic Device (CIED)
Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE) Following Certain Orthopedic Procedures:
Total Knee Replacement
Hip Replacement
Iatrogenic Pneumothorax with Venous CatheterizationRate this question:
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- 6.
Which form must be completed in order to permit a specific disclosure of protected health information?
- A.
Consent
- B.
Authorization
- C.
Access
- D.
Redisclosure
Correct Answer
B. AuthorizationExplanation
Authorization must be completed in order to permit a specific disclosure of protected health information. Consent refers to the general permission given by a patient for the use and disclosure of their health information, while authorization is a more specific and detailed form that allows the release of protected health information for a particular purpose. Access refers to the ability of individuals to view and obtain their own health information. Redisclosure refers to the sharing of health information that has already been disclosed once. Therefore, authorization is the correct form to be completed for a specific disclosure of protected health information.Rate this question:
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- 7.
What term is used when protected health information has been disclosed inappropriately?
- A.
Exposure
- B.
Breach
- C.
Violation
- D.
Infraction
Correct Answer
B. BreachExplanation
When protected health information has been disclosed inappropriately, it is referred to as a breach. A breach occurs when there is an unauthorized release or access to sensitive health information, compromising the privacy and security of the individual's personal health data. This term is commonly used in the context of healthcare and data protection regulations to describe situations where there has been a violation of privacy rules and regulations.Rate this question:
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- 8.
What is the term used for applying the HIPAA privacy rule over state rules which are less strict?
- A.
Exception
- B.
Preemption
- C.
Exclusion
- D.
Predominance
Correct Answer
B. PreemptionExplanation
Preemption means to supercedeRate this question:
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- 9.
According to the UHDDS, section III, the definition of "other diagnoses" is all conditions that:
- A.
Coexist at the time of admission, that develop subsequently, or that affect the treatment received or the length of stay
- B.
Receive evaluation and are documented by the physician
- C.
Receive clinical evaluation, therapeutic treatment, further evaluation, extend the length of stay, increase nursing monitoring/care
Correct Answer
A. Coexist at the time of admission, that develop subsequently, or that affect the treatment received or the length of stayExplanation
Other Diagnosis Coexist at the time of admission, that develop subsequently, or that affect the treatment received or the length of stay
Secondary Diagnosis Receives clinical evaluation, therapeutic treatment, further evaluation, extends the length of stay, or increases nursing monitoring and care
The Uniform Hospital Discharge Data Set, which is referred to as the 'UHDDS,' is the core data set for inpatient admissions. The data is collected on inpatient hospital discharges for Medicare and Medicaid programs. Much of the required information can be located on the patient's face sheet.Rate this question:
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- 10.
Which patient specific UHDDS items also have the potential to impact MS-DRG
- A.
Race and Residence
- B.
Residence and Sex
- C.
Sex and discharge disposition
- D.
Discharge disposition and race
Correct Answer
C. Sex and discharge dispositionExplanation
The Uniform Hospital Discharge Data Set, which is referred to as the 'UHDDS,' is the core data set for inpatient admissions. The data is collected on inpatient hospital discharges for Medicare and Medicaid programs. Much of the required information can be located on the patient's face sheet.Rate this question:
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- 11.
Noncompliance or complication of care codes are to be used with an _____________ code (and vice versa) to indicate intent, if known.
Correct Answer
underdosingExplanation
First, the effect (hypertension, syncope, etc)
then the underdosing code
and finally the noncompliance or complication of care code
***Codes for underdosing should never be assigned as principal or
first-listed codes.Rate this question:
- 12.
A patient is admitted with an acute inferior myocardial infarction and discharged alive. Which condition would increase the MS-DRG weight?
- A.
Respiratory failure
- B.
A fib
- C.
Hypertension
- D.
History of myocardial infarction
Correct Answer
A. Respiratory failureExplanation
According to Medicare, a major surgery has a global period of 90 days, and a minor surgery has a global period of either 10 or 0 days. Thus, the time frame of, not the complexity of, the surgery determines whether a surgery is major or minor.Rate this question:
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- 13.
If the principal diagnosis is an initial anterior wall myocardial infarction, which procedure will result in the highest MS-DRG assignment?
- A.
Mechanical ventilator
- B.
Insertion central venous catheter
- C.
Right heart cardiac catheterization
- D.
Transbronchial lung biopsy
Correct Answer
D. Transbronchial lung biopsyExplanation
If a HAC diagnosis is POA it will be classified as CC or MCC and will impact MS-DRG reimbursement by raising the relative weight.Rate this question:
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- 14.
PHI stands for
- A.
Personal Health Information
- B.
Private Health Information
- C.
Protected Health Information
- D.
Patient Health Information
- E.
Determining payment-related condition that require direct reference to HCPCS or modifiers
Correct Answer
C. Protected Health InformationExplanation
PHI stands for Protected Health Information. This term refers to any individually identifiable health information that is created, received, maintained or transmitted by a covered entity. It includes any information about a person's past, present or future physical or mental health, as well as any healthcare services provided to them. Protected Health Information is subject to strict privacy and security regulations under the Health Insurance Portability and Accountability Act (HIPAA) to ensure the confidentiality and integrity of patients' health information.Rate this question:
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- 15.
A pt is admitted for emergency treatment of end stage renal disease. The following day his personal physician comes to the hospital for a checkup and chart review. what e/m service would be applied to the physician visist?
- A.
Office or other outpatient services
- B.
Initial hospital care
- C.
Subsequent hospital care
- D.
Initial observation care
Correct Answer
C. Subsequent hospital careExplanation
As long as she is honest about her current credential she may ethically apply for the position. She may be told that she is not applicable until she gets her RHIA. Honesty and transparency are key.Rate this question:
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- 16.
A bilateral salpingectomy is removal of ________________________
Correct Answer
fallopian tubesExplanation
A bilateral salpingectomy is a surgical procedure that involves the removal of both fallopian tubes. This procedure is typically performed for various reasons, including sterilization, treatment of certain gynecological conditions, or as a preventive measure for individuals at high risk of developing ovarian cancer. By removing the fallopian tubes, the procedure effectively eliminates the possibility of fertilization and prevents the eggs from reaching the uterus, thus providing a permanent form of contraception.Rate this question:
- 17.
Which form would a patient be required for a patient to assume responsibility for a service that may be denied by Medicare
- A.
HIPAA
- B.
CMS 1450
- C.
ABN (Advance Beneficiary Notice of Noncoverage)
- D.
MIPS (Merit-based Incentive Payment System)
Correct Answer
C. ABN (Advance Beneficiary Notice of Noncoverage)Explanation
The CMS-1450 form (aka UB-04 at present) can be used by an institutional provider to bill a Medicare fiscal intermediary (FI) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of claims. The UB04 claim form is used to submit claims for inpatient AND outpatient services by institutional facilities (for example, outpatient departments, Rural Health Clinics, chronic dialysis and Adult Day Health Care).
CMS 1500 is used only by the physicians, not hospitals (non-institution based), or supplier to bill Medicare carriers and durable medical equipment regional carriers (DMERCs) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of claims. It is also used for billing of some Medicaid State Agencies. Please contact your Medicaid State Agency for more details.Rate this question:
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- 18.
What services can be coded IN ADDITION to Critical Care Services?
- A.
CPR
- B.
Endotracheal Intubation
- C.
Defibrillation
- D.
A and B are correct
Correct Answer
D. A and B are correctExplanation
CAN BE BILLED SEPARATELY
CPR
Endotracheal intubation
Central line placement
Intraosseous placement
Tube thoracostomy
Temporary transvenous pacemaker
Electrocardiogram - routine ECG with at least 12 leads; interpretation and report only
Elective electrical cardioversion
Rate this question:
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- 19.
Repair of the anterior cruciate ligament of the knee is coded to the knee body part in the ________________ body system.
Correct Answer
bursae and ligamentsExplanation
The correct answer is bursae and ligaments because the anterior cruciate ligament is a ligament located in the knee joint. Ligaments are part of the bursae and ligaments body system, which includes the connective tissues that support and stabilize joints. Therefore, when coding the repair of the anterior cruciate ligament, it would be classified under the bursae and ligaments body system.Rate this question:
- 20.
If a listing for ankle does not exist, the ___________ body part is used
Correct Answer
footExplanation
If a listing for ankle does not exist, the foot body part is used. This implies that when referring to a specific body part in a listing or categorization, if there is no separate category for the ankle, it is grouped under the foot category. This suggests that the ankle is considered a part of the foot and is not distinguished as a separate body part in this particular context.Rate this question:
- 21.
Spinal tap is also known as a ____________________
Correct Answer
diagnostic lumbar punctureExplanation
Spinal tap is a medical procedure in which a needle is inserted into the lower back to collect cerebrospinal fluid for diagnostic purposes. This procedure is commonly referred to as a diagnostic lumbar puncture, as it is used to diagnose various conditions such as infections, bleeding, or inflammation in the central nervous system.Rate this question:
- 22.
If noted, post pregnancy hypokalemia, must also be coded with _______________ nutritional and metabolic disease complicating the puerperium
Correct Answer
endocrineExplanation
Post pregnancy hypokalemia is a condition characterized by low levels of potassium in the blood that occurs after childbirth. It is a metabolic disorder that is caused by hormonal changes in the body during the postpartum period. Since it is a metabolic disorder, it should be coded with a nutritional and metabolic disease complicating the puerperium, which falls under the endocrine category. Therefore, the correct answer is endocrine.Rate this question:
- 23.
Post partum anemia is ___________ coded
Correct Answer
alwaysExplanation
Postpartum anemia is always coded. This means that regardless of the circumstances or severity of the anemia, it must always be documented and assigned a code for proper medical record keeping and billing purposes. Anemia after childbirth is a common occurrence due to the loss of blood during delivery, and it is important to track and manage this condition for the well-being of the mother.Rate this question:
- 24.
An ileus is usually a _______________ COMPLICATION and should be coded. A separate code is used for a complication of OBSTETRICAL SURGERY like a c-section
Correct Answer
post op, postopExplanation
Ileus refers to the intolerance of oral intake due to inhibition of the gastrointestinal propulsion without signs of mechanical obstruction.Rate this question:
- 25.
Radiating pain, think ____________
Correct Answer
radiculopathyExplanation
Radiculopathy refers to a condition where there is compression or irritation of a nerve root, usually in the spine. This can result in radiating pain, which means that the pain travels from the site of the nerve compression or irritation to other parts of the body supplied by that nerve. Therefore, when experiencing radiating pain, it is likely that the cause is radiculopathy.Rate this question:
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Mar 01, 2023Quiz Edited by
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Apr 18, 2017Quiz Created by
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